Hello, my name is Tiffany Baker and I am a nursing student at the 
University of North Dakota. I have recently had my OB clinical and was 
fortunate enough to see the delivery of twins! As I was watching, however, 
I was wondering what she was going to do about breastfeeding. I have 
learned much about teaching a parent of a singleton to breastfeed, however 
I have never had to deal with multiples. 
	I did some research to back up my knowledge acquired at UND. I was 
interested in the importance of early breastfeeding. Riordan, Gill-Hopple, 
and Angeron (2005) did some research and found that early in the postpartum 
period, rooting and observed swallowing appear to be important estimates of 
human milk intake as well as a critical time for the establishment of 
breastfeeding. This information should be taught to the mom so she would 
understand the importance of early breastfeeding versus bottle feeding 
until she was ready to deal with both newborns. 
	In another report, however, I found that when both twins are ready 
to breastfeed, many mothers during the first few post partum days, do not 
have enough milk for both children. Eventually, the mothers supply 
increases and shouldn’t pose a problem. It is recommended for the mother to 
take at least a three-hour break between feedings as well as to have the 
twins (or other multiples) feed equally at each breast (R. Hattori and H. 
Hattori, 1999). 
	I began to think of ways to ensure the babies got enough breast 
milk, and came across a research report that focused on breast pumps with 
multiple births. The reason the study was performed was because the 
researcher realized that with mothers of multiples there are challenges 
associated with establishing an adequate milk supply as well as the 
initiation of more than one infant to the breast after delivery. This study 
also confirmed my previous research by stating that their data showed that 
the earlier infants get to the breast the more likely they are to feed on 
human milk for longer durations. (Geraghy, Khoury, and Kalkwarf, 2005). 
	I was wondering if there was a schedule that could be provided to 
the mother of multiples that included time at the breast as well as time 
pumping (if she chooses).  Would the combination of breastfeeding and 
breast pumping be more beneficial for the mother and what type of schedule 
should be set for the infants to experience the mothers nipple and the 
bottle nipple? I included the information about early breastfeeding because 
I feel that would be an important part of the schedule as well. 
Thank you.
Tiffany Baker, SN 

Geraghy, S.R., Khoury, J.C., and Kalkwarf, H.J. (2005). Human Milk Pumping 
     
     Rates of Mothers of Singletons and Mothers of Multiples. Journal of 
     
     Human Lactation. 21(4). 413-420.

Hattori, R., Hattori, H. (1999). Breastfeeding Twins: Guidelines for 

     Success. Birth Issues in Perinatal Care. 26(1). 37-42.

Riordan, J., Gill-Hopple, K., and Angeron, J. (2005). Indicators of 

     Effective Breastfeeding and Estimates of Breast Milk Intake. Journal 

     of Human Lactation. 21(4). 406-412.

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